Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

The Journal Gazette reports that testing shows that the student's tuberculosis is a virulent strain that doesn't respond to the most powerful first-line drugs used to treat the illness. It is the first known case of multidrug-resistant tuberculosis in Allen County, Health Department spokesman John Silcox said.

Tuberculosis is caused by bacteria spread from person to person through the air. TB usually affects the lungs, and can lead to symptoms such as chest pain and coughing up blood.

Multidrug-resistant TB does not respond to the common drugs used to treat the disease and must be treated with a second line of drugs, said Dr. Deborah McMahon, the Allen County health commissioner. If that doesn't work, a third line of drugs is needed, until something works.

"The farther you go, the less effective the treatment," McMahon said.

A person with a regular case of TB is treated with four drugs over six months; a person with multidrug-resistant TB must be treated with six medications including shots for two years, McMahon said. The person also must have the infected part of his or her lungs surgically removed, she said.

The student is in isolation and undergoing treatment and no one else associated with the person has been identified with active TB, Silcox said. A second round of TB skin testing is required in eight to 10 weeks to rule out TB infection, so it will likely be a few months before health officials know whether anyone else was infected.

Parents of students who might be affected were contacted by phone and a letter was sent home to families to explain the situation and provide additional information.

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